POS0324 RISK OF CARDIOVASCULAR COMORBIDITIES IN RHEUMATIC DISEASES
Authors: H. K. Aaramaa, P. Isomäki, N. Mars, M. Helminen, A. Kerola, A. Palomäki, K. Eklund, J. Gracia Tabuenca, J. Sinisalo
Journal: Annals of the Rheumatic Diseases (2022)

Background Cardiovascular diseases (CVD’s) are the most significant comorbidities in rheumatic diseases, causing also increased mortality. [1,2] However, there is only limited data on how the risk of CV comorbidities varies between different rheumatic diseases. Objectives The aim of our study was to estimate the risk of certain CV comorbidities across rheumatic diseases. Methods The ongoing FinnGen project links nationwide healthcare register data with genome data. The study (data freeze 7) included 321 302 individuals, and from this group we identified patients with seropositive (N=4293) and seronegative (N=1733) rheumatoid arthritis (RA), ankylosing spondylitis (AS, N=1247), psoriatic arthritis (PsA, N=1235), systemic lupus erythematosus (SLE, N=386), primary Sjogren’s syndrome (pSS, N=557) and gout (N=2178). Each patient was matched based on age, sex and municipality of residence with twenty individuals without any rheumatic conditions. The CV comorbidities studied were any CV disease (CVD), major coronary heart disease event (myocardial infarction and/or revascularization; CHD), ischemic stroke, atrial fibrillation and flutter (AF), deep vein thrombosis of lower extremities (DVT) and pulmonary embolism (PE), chronic heart failure (CHF) and valvular heart disease excluding rheumatic fever (VHD). From the prevalence of each CV disease among rheumatic disease cohorts, we calculated the risk ratio (RR) for each CV disease by comparing the prevalence of these diseases between rheumatic diseases and controls. Results The average age at the time of diagnosis ranged from 39.6 to 64.4 years, and the average duration of follow-up varied from 9 to 19.5 years in different rheumatic diseases. The risk for any CVD was elevated in all rheumatic disease cohorts with RR varying from 1.14 in seropositive RA to 1.65 in SLE. SLE patients carried the highest relative risk for CV comorbidities, demonstrating over 2.5-fold risk for DVT/PE (RR 3.57), stroke (RR 2.57), CHF (RR 2.64) and VHD (RR 2.98). At least two-fold risk compared to controls was identified for AF (RR 2.03), DVT/PE (RR 2.44) and CHF (RR 3.03) in patients with gout, for DVT/PE (RR 2.15) and CHF (RR 2.0) in patients with pSS, and for DVT/PE (RR 2.03) in patients with PsA. Seropositive and seronegative RA demonstrated similar CV risk profiles. In patients with seropositive or seronegative RA, PsA, pSS or SLE, DVT/PE demonstrated the highest RR’s among various CV comorbidities. Conclusion The risk of CV comorbidities is increased in all studied rheumatic diseases, with the largest effects observed in patients with SLE and gout. Among CV comorbidities, DVT/PE displayed the largest effect sizes in several rheumatic diseases. The current results further strengthen the importance of evaluating and treating risk factors for CV comorbidities across rheumatic diseases, focusing also to the excess risk for thromboses. References [1]Han C., Robinson DW Jr et al. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. J Rheumatol. 2006;33(11):2167-2172. [2]Avina-Zubieta JA, Choi HK et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008; 15;59(12):1690-1697. Acknowledgements Special thanks to Finnish Foundation of Rheumatology Research and the Foundation of Maire Lisko for issuing research grants to help with the research process and writing of this abstract. Disclosure of Interests Hanna-Kaisa Aaramaa: None declared, Pia Isomäki Speakers bureau: Speaker or chair for AbbVie, Eli Lilly and Pfizer., Consultant of: Consultant for AbbVie, Eli Lilly, Pfizer, Roche and ViforPharma., Grant/research support from: A research grant from Pfizer., Nina Mars: None declared, Mika Helminen: None declared, Anne Kerola: None declared, Antti Palomäki Speakers bureau: Lecture free from Pfizer and Sanofi, Consultant of: Consulting fee from Abbvie, Amgen and Pfizer, Kari Eklund: None declared, Javier Gracia Tabuenca: None declared, Juha Sinisalo: None declared